Risankizumab Improved Psoriasis Symptoms in Patients Who Previously Failed IL-17 Therapy

By Jeff Craven, MD /alert Contributor
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A proportion of patients with psoriasis who previously failed interleukin (IL)-17 treatment showed improvement after receiving risankizumab, according to recent research published in Dermatologic Therapy.

“Our real-life monocentric retrospective experience confirmed the effectiveness and safety of risankizumab which do not seem to be reduced by previous anti-IL-17 treatments failure. However, further studies are needed to confirm our results as well as to gain data to support the best evidence based biologic selection algorithm,” Matteo Megna, MD, of the section of dermatology, department of clinical medicine and surgery at the University of Naples Federico II, Naples, and colleagues wrote in their study.

Megna and colleagues evaluated 39 of 89 patients (43.8%) with psoriasis who failed IL-17 therapy and met the inclusion criteria: dermatologist-confirmed moderate-to-severe plaque psoriasis and treatment with an IL-17 therapy such as brodalumab, ixekizumab, and/or secukinumab that ended in primary or secondary treatment failure. The patients received subcutaneous risankizumab at week 0, week 4, and every 12 weeks after that up to 52 weeks. Patients in the study were mean 50.5 years old, 66.7% were men, and the mean psoriasis duration was 17.2 years. Of the original enrolled patients, 15 also had psoriatic arthritis and 9 patients had nail involvement with their psoriasis. 

The researchers found 6 patients had a 90% of greater reduction in psoriasis activity severity index (PASI) scores from baseline (PASI 90), and 3 patients had achieved PASI 100. Patients experienced a significant reduction at 52 weeks compared with baseline regarding PASI score (13.7 vs 5.8; P < .0001) and body surface area (21.9 vs 1.9; P < .0001). There was also a significant improvement among patients with nail psoriasis as measured by the nail psoriasis severity index compared with baseline at 16 weeks (9.2 vs 3.1; P < .01) and up to 52 weeks (9.2 vs 1.4; P < .0001)

Only 1 patient discontinued due to primary inefficacy, and 3 patients discontinued due to secondary inefficacy. The researchers reported no serious adverse events occurred in the study in either group.

“Certainly, further studies are required to compare the efficacy of risankizumab in patients who previously failed anti-IL17 to patients anti IL17 naïve as well as further experiences will allow to improve the knowledge on the biologic armamentarium guiding clinicians in daily practice,” Megna and colleagues concluded.


Disclosures: Some authors declared financial ties to drugmakers. See full study for details.

Photo Credit: Getty Images.

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